Displaying publications 1 - 20 of 218 in total

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  1. Chai WJ, Abd Hamid AI, Abdullah JM
    Front Psychol, 2018;9:401.
    PMID: 29636715 DOI: 10.3389/fpsyg.2018.00401
    Since the concept of working memory was introduced over 50 years ago, different schools of thought have offered different definitions for working memory based on the various cognitive domains that it encompasses. The general consensus regarding working memory supports the idea that working memory is extensively involved in goal-directed behaviors in which information must be retained and manipulated to ensure successful task execution. Before the emergence of other competing models, the concept of working memory was described by the multicomponent working memory model proposed by Baddeley and Hitch. In the present article, the authors provide an overview of several working memory-relevant studies in order to harmonize the findings of working memory from the neurosciences and psychological standpoints, especially after citing evidence from past studies of healthy, aging, diseased, and/or lesioned brains. In particular, the theoretical framework behind working memory, in which the related domains that are considered to play a part in different frameworks (such as memory's capacity limit and temporary storage) are presented and discussed. From the neuroscience perspective, it has been established that working memory activates the fronto-parietal brain regions, including the prefrontal, cingulate, and parietal cortices. Recent studies have subsequently implicated the roles of subcortical regions (such as the midbrain and cerebellum) in working memory. Aging also appears to have modulatory effects on working memory; age interactions with emotion, caffeine and hormones appear to affect working memory performances at the neurobiological level. Moreover, working memory deficits are apparent in older individuals, who are susceptible to cognitive deterioration. Another younger population with working memory impairment consists of those with mental, developmental, and/or neurological disorders such as major depressive disorder and others. A less coherent and organized neural pattern has been consistently reported in these disadvantaged groups. Working memory of patients with traumatic brain injury was similarly affected and shown to have unusual neural activity (hyper- or hypoactivation) as a general observation. Decoding the underlying neural mechanisms of working memory helps support the current theoretical understandings concerning working memory, and at the same time provides insights into rehabilitation programs that target working memory impairments from neurophysiological or psychological aspects.
  2. Ng PM, Abdullah JM, Idris Z, Ghani ARI, Abdul Halim S
    Malays J Med Sci, 2021 Oct;28(5):142-148.
    PMID: 35115897 DOI: 10.21315/mjms2021.28.5.15
    The neuro-ophthalmological evaluation is done to assess the integrity of cranial nerves II, III, IV, VI. This work does not intend to substitute the examination in a fully equipped ophthalmology suite. The aim of this manuscript is to describe bedside examination of the eye by using simple apparatus that are easily available. This work incorporates the usage of smartphone application, as smartphone is deemed an accessory in almost every resident's pocket during review of patients as a consult in the emergency department. However, the essence of traditional physical examination remains the fundamental. Understanding of neuroanatomy and neurophysiology of the eye and the central nervous system can enhance the clinician's performance at the bedside.
  3. Sulong S, Yusoff AA, Zainuddin N, Abdullah JM, Pannatil JG, Jaafar H, et al.
    Malays J Med Sci, 2004 Jan;11(1):37-43.
    PMID: 22977358 MyJurnal
    The new millennium has been regarded as a genomic era. A lot of researchers and pathologists are beginning to understand the scientific basis of molecular genetics and relates with the progression of the diseases. Central nervous system (CNS) tumours are among the most rapidly fatal of all cancers. It has been proposed that the progression of malignant tumours may result from multi-step of genetic alterations, including activation of oncogenes, inactivation of tumour suppressor genes and also the presence of certain molecular marker such as telomerase activity. In this paper, we review some recent data from the literature, including our own studies, on the molecular genetics analysis in CNS tumours. Our studies have shown that two types of tumour suppressor genes, p53 and PTEN were involved in the development of these tumours but not in p16 gene among the patients from Hospital Universiti Sains Malaysia (HUSM). Telomerase activity also has been detected in various types of CNS tumours. Thus, it is important to assemble all data which related to this study and may provide as a vital information in a new approach to neuro-oncology studies in Malaysia.
  4. Sumari P, Idris Z, Abdullah JM
    Malays J Med Sci, 2017 Mar;24(1):1-9.
    PMID: 28381924 DOI: 10.21315/mjms2017.24.1.1
    The Academy of Sciences Malaysia and the Malaysian Industry-Government group for High Technology has been working hard to project the future of big data and neurotechnology usage up to the year 2050. On the 19 September 2016, the International Brain Initiative was announced by US Under Secretary of State Thomas Shannon at a meeting that accompanied the United Nations' General Assembly in New York City. This initiative was seen as an important effort but deemed costly for developing countries. At a concurrent meeting hosted by the US National Science Foundation at Rockefeller University, numerous countries discussed this massive project, which would require genuine collaboration between investigators in the realms of neuroethics. Malaysia's readiness to embark on using big data in the field of brain, mind and neurosciences is to prepare for the 4th Industrial Revolution which is an important investment for the country's future. The development of new strategies has also been encouraged by the involvement of the Society of Brain Mapping and Therapeutics, USA and the International Neuroinformatics Coordinating Facility.
  5. Mustafa Z, Shamsuddin HS, Ideris A, Ibrahim R, Jaafar H, Ali AM, et al.
    Biomed Res Int, 2013;2013:248507.
    PMID: 23586025 DOI: 10.1155/2013/248507
    Oncolytic viruses have been extensively evaluated for anticancer therapy because this virus preferentially infects cancer cells without interfering with normal cells. Newcastle Disease Virus (NDV) is an avian virus and one of the intensively studied oncolytic viruses affecting many types of cancer including glioma. Nevertheless, the capability of NDV infection on heterogeneous glioma tissue in a cerebrospinal fluid atmosphere has never been reported. Recently, Rac1 is reported to be required for efficient NDV replication in human cancer cells and established a link between tumourigenesis and sensitivity to NDV. Rac1 is a member of the Rho GTPases involved in the regulation of the cell migration and cell-cycle progression. Rac1 knockdown leads to significant inhibition of viral replication. In this work, we demonstrated that NDV treatment led to significant reduction of tumour tissue viability of freshly isolated heterogeneous human brain tumour slice, known as an ex vivo glioma acute slice (EGAS). Analysis of gene expression indicated that reduced tissue viability was associated with downregulation of Rac1. However, the viability reduction was not persistent. We conclude that NDV treatment induced EGAS viability suppression, but subsequent downregulation of Rac1 gene may reduce the NDV replication and lead to regrowth of EGAS tissue.
  6. Sam JE, Kandasamy R, Wong ASH, Ghani ARI, Ang SY, Idris Z, et al.
    World Neurosurg, 2021 12;156:e381-e391.
    PMID: 34563715 DOI: 10.1016/j.wneu.2021.09.074
    OBJECTIVE: Subgaleal drains are generally deemed necessary for cranial surgeries including decompressive craniectomies (DCs) to avoid excessive postoperative subgaleal hematoma (SGH) formation. Many surgeries have moved away from routine prophylactic drainage but the role of subgaleal drainage in cranial surgeries has not been addressed.

    METHODS: This was a randomized controlled trial at 2 centers. A total of 78 patients requiring DC were randomized in a 1:1:1 ratio into 3 groups: vacuum drains (VD), passive drains (PD), and no drains (ND). Complications studied were need for surgical revision, SGH amount, new remote hematomas, postcraniectomy hydrocephalus (PCH), functional outcomes, and mortality.

    RESULTS: Only 1 VD patient required surgical revision to evacuate SGH. There was no difference in SGH thickness and volume among the 3 drain types (P = 0.171 and P = 0.320, respectively). Rate of new remote hematoma and PCH was not significantly different (P = 0.647 and P = 0.083, respectively), but the ND group did not have any patient with PCH. In the subgroup analysis of 49 patients with traumatic brain injury, the SGH amount of the PD and ND group was significantly higher than that of the VD group. However, these higher amounts did not translate as a significant risk factor for poor functional outcome or mortality. VD may have better functional outcome and mortality.

    CONCLUSIONS: In terms of complication rates, VD, PD, and ND may be used safely in DC. A higher amount of SGH was not associated with poorer outcomes. Further studies are needed to clarify the advantage of VD regarding functional outcome and mortality, and if ND reduces PCH rates.

  7. Abdullah JY, Saidin M, Rajion ZA, Hadi H, Mohamad N, Moraes C, et al.
    Malays J Med Sci, 2021 Feb;28(1):1-8.
    PMID: 33679214 DOI: 10.21315/mjms2021.28.1.1
    Perak Man, named after the state where the skeleton was found, was the most complete skeleton found in Southeast Asia. The funerary artefacts indicate that Perak Man was highly respected, as he was buried at the centre of the highest cave in Lenggong, and he was the only person buried there. A copy of the original skull was made using computed tomography (CT) and 3D printing. Based on the internal structure of the reconstructed skull, the estimated intracranial volume (ICV) is 1,204.91 mL. The hypothetical face of Perak Man was reconstructed according to established forensic methods. Based on his presumed status, Perak Man was likely a respected person in the group and, perhaps, a shaman and the most knowledgeable person in the group regarding survival, hunting, gathering and other aspects of Palaeolithic daily life.
  8. Abd Wahab F, Abdullah S, Abdullah JM, Jaafar H, Md Noor SS, Wan Mohammad WMZ, et al.
    Malays J Med Sci, 2016 Nov;23(6):25-34.
    PMID: 28090176 MyJurnal DOI: 10.21315/mjms2016.23.6.3
    Ranking as the most communicable disease killer worldwide, tuberculosis, has accounted with a total of 9.6 million new tuberculosis cases with 1.5 million tuberculosis-related deaths reported globally in 2014. Tuberculosis has remain as an occupational hazard for healthcare workers since 1920s and due to several tuberculosis outbreaks in healthcare settings in the early 1990s, the concern about the transmission to both patients and healthcare workers has been raised. Healthcare workers have two to three folds greater the risk of active tuberculosis than the general population. Several studies on knowledge, attitude and practices on tuberculosis among healthcare workers worldwide have revealed that majority of the participated healthcare workers had good knowledge on tuberculosis. Most of the healthcare workers from South India and South Africa also reported to have positive attitude whereas a study in Thailand reported that most of the healthcare providers have negative attitude towards tuberculosis patients. Nevertheless, majority of the healthcare workers have low level of practice on tuberculosis prevention. An improved communication between healthcare workers and the patients as well as their families is the key to better therapeutic outcomes with good knowledge, attitude and preventive practice towards tuberculosis.
  9. Mat Nayan SA, Mohd Haspani MS, Abd Latiff AZ, Abdullah JM, Abdullah S
    J Clin Neurosci, 2009 Dec;16(12):1567-71.
    PMID: 19793660 DOI: 10.1016/j.jocn.2009.01.036
    We studied the efficacy of two surgical methods used for the treatment of intracranial subdural empyema (ISDE) at our centre. A cross-sectional study (1999-2005) of 90 patients with non-traumatic supratentorial ISDE revealed that the two surgical methods used for empyema removal were burr hole/s and drainage (50 patients, 55.6%) and a cranial bone opening procedure (CBOP) (40 patients, 44.4%). Patients in the CBOP group had a better result in terms of clinical improvement (chi-squared analysis, p=0.006) and clearance of empyema on brain CT scan (chi-squared analysis, p<0.001). Reoperation was more frequent among patients who had undergone burr hole surgery (multiple logistic regression, p<0.001). The outcome and morbidity of ISDE survivors were not related to the surgical method used (p>0.05). The only factor that significantly affected the morbidity of ISDE was level of consciousness at the time of surgery (multiple logistic regression, p<0.001). We conclude that CBOP and evacuation of the empyema is a better surgical method for ISDE than burr hole/s and drainage. Wide cranial opening and empyema evacuation improves neurological status, gives better clearance of the empyema and reduces the need for reoperation. Level of consciousness at the time of presentation is a predictor of the morbidity of ISDE. Thus, aggressive surgical treatment should occur as early as possible, before the patient deteriorates.
  10. Chong PN, Sangu M, Huat TJ, Reza F, Begum T, Yusoff AAM, et al.
    Malays J Med Sci, 2018 Nov;25(6):28-45.
    PMID: 30914877 MyJurnal DOI: 10.21315/mjms2018.25.6.4
    Background: Following brain injury, development of hippocampal sclerosis often led to the temporal lobe epilepsy which is sometimes resistant to common anti-epileptic drugs. Cellular and molecular changes underlying epileptogenesis in animal models were studied, however, the underlying mechanisms of kainic acid (KA) mediated neuronal damage in rat hippocampal neuron cell culture alone has not been elucidated yet.

    Methods: Embryonic day 18 (E-18) rat hippocampus neurons were cultured with poly-L-lysine coated glass coverslips. Following optimisation, KA (0.5 μM), a chemoconvulsant agent, was administered at three different time-points (30, 60 and 90 min) to induce seizure in rat hippocampal neuronal cell culture. We examined cell viability, neurite outgrowth density and immunoreactivity of the hippocampus neuron culture by measuring brain derived neurotrophic factor (BDNF), γ-amino butyric acid A (GABAA) subunit α-1 (GABRA1), tyrosine receptor kinase B (TrkB), and inositol trisphosphate receptor (IP3R/IP3) levels.

    Results: The results revealed significantly decreased and increased immunoreactivity changes in TrkB (a BDNF receptor) and IP3R, respectively, at 60 min time point.

    Conclusion: The current findings suggest that TrkB and IP3 could have a neuroprotective role which could be a potential pharmacological target for anti-epilepsy drugs.

  11. Idris Z, Tan YC, Kandasamy R, Ghani RI, Abdullah JM
    J Neurol Surg A Cent Eur Neurosurg, 2017 Mar;78(2):210-215.
    PMID: 26968147 DOI: 10.1055/s-0035-1571161
    Symptomatic intracranial arachnoid cysts are commonly treated using neuroendoscopy. Cysts located within the posterior fossa may present a greater surgical challenge to the neurosurgeon due to the numerous vital neurovascular structures located within this confined space. Adding neuronavigation during endoscopy helps a neurosurgeon to visualize and utilize both anterior and posterior corridors safely to access and manage these lesions. We present three symptomatic posterior fossa arachnoid cysts that were treated successfully using minimally invasive neuronavigation-guided endoscopic neurosurgery utilizing the anterior transfrontal transaqueductal, anterior transfrontal transtrigonal, and posterior suboccipital infratentorial supracerebellar approaches.
  12. Arumugam A, Tan SE, Tan SL, Tan JE, Hussin FH, Zenian MS, et al.
    Malays J Med Sci, 2023 Jun;30(3):93-102.
    PMID: 37425386 DOI: 10.21315/mjms2023.30.3.8
    BACKGROUND: Intracerebral haemorrhage (ICH) can be devastating, particularly if haematoma expansion occurs. The efficacy of tranexamic acid (TXA), an anti-fibrinolytic agent, in reducing haematoma expansion is now being studied worldwide. However, the optimal dosage of TXA has yet to be determined. This study was designed to further establish the potential of different doses of TXA.

    METHODS: A double-blinded, randomised, placebo-controlled study was carried out among adults with non-traumatic ICH. Eligible study subjects were randomly assigned to receive placebo, 2-g TXA treatment or 3-g TXA treatment. Haematoma volumes before and after intervention were measured using the planimetric method.

    RESULTS: A total of 60 subjects with 20 subjects in each treatment group were recruited for this study. Among the 60 subjects, the majority were male (n = 36, 60%), had known cases of hypertension (n = 43, 71.7%) and presented with full Glasgow coma scale (GCS) (n = 41, 68.3%). The results showed that there was no statistically significant difference (P = 0.315) in the mean changes of haematoma volume when compared with three study groups using ANCOVA, although the 3-g TXA group was the only group that showed haematoma volume reduction (mean reduction of 0.2 cm3) instead of expansion as in placebo (mean expansion 1.8 cm3) and 2-g TXA (mean expansion 0.3 cm3) groups. Good recovery was observed in all study groups, with only three subjects being moderately disabled. No adverse effects were reported in any of the study groups.

    CONCLUSION: To the best of our knowledge, this is the first clinical study using 3 g of TXA in the management of non-traumatic ICH. From our study, 3 g of TXA may potentially be helpful in reducing haematoma volume. Nonetheless, a larger-scale randomised controlled trial should be carried out to further establish the role of 3 g of TXA in non-traumatic ICH.

  13. Arumugam A, A Rahman NA, Theophilus SC, Shariffudin A, Abdullah JM
    Malays J Med Sci, 2015 Dec;22(Spec Issue):62-71.
    PMID: 27006639 MyJurnal
    Mortality and morbidity associated with intracerebral hemorrhage is still high. Up to now, there are no evidence-based effective treatments for acute ICH. This study is to assess the effect of tranexamic acid (TXA) on hematoma growth of patients with spontaneous ICH compared to a placebo.
  14. Zakaria MA, Abdullah JM, George JP, Mutum SS, Lee NN
    Med J Malaysia, 2006 Jun;61(2):229-32.
    PMID: 16898318 MyJurnal
    Third ventricular cavernous angiomas are rare vascular malformations of the brain. We report an eight-year old boy with a rare third ventricular cavernous angioma that hemorrhaged presenting with symptoms of acute hydrocephalus. Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) showed a heterogenous ill-defined, solid and cystic intraventricular mass in the third ventricle which was mildly enhanced with contrast and there was associated hydrocephalus. The mass was removed with success and follow up after two years revealed no neurological abnormalities.
  15. Hamzah N, Musa KI, Romli MH, Chen XW, Rahim MZA, Abdullah JM, et al.
    BMC Public Health, 2023 Jan 30;23(1):198.
    PMID: 36717840 DOI: 10.1186/s12889-023-15076-1
    BACKGROUND: Post-stroke complications affect the informal caregivers equally as the stroke survivors, especially those who have a moderate to worst prognosis in functional capacity recovery. Caregiver Assessment of Function and Upset (CAFU) is one of the common tools used in both research and clinical practice to measure the patient's dependency level and the stroke caregivers' upset level.

    OBJECTIVE: This study aimed to translate and validate the CAFU instrument into the Malay language and test the validity and reliability of the CAFU among informal stroke caregivers in Malaysia.

    METHODS: A standard forward-backward translation method was employed to translate CAFU. Subsequently, 10 expert panels were included in the validation process, and thereafter reliability testing was conducted among 51 stroke caregivers. The validation of the instrument was determined by computing the content validity indices (CVIs), and we used the Cronbach's alpha method to explore the internal consistency of the overall score and subscales scores of the Malay-CAFU. Finally, the explanatory factor analysis used principal component extraction and a varimax rotation to examine construct validity.

    RESULTS: All items of the Malay-CAFU had satisfactory item-level CVI (I-CVI), with values greater than 0.80, and the scale-level CVI (S-CVI) was 0.95. These results indicate that the Malay-CAFU had good relevancy. The internal consistency for the reliability test showed a Cronbach's alpha value of 0.95 for the overall score. The eigenvalues and scree plot supported a two-factor structural model of the instrument. From the explanatory factor analysis, the factor loadings ranged from 0.82 to 0.90 and 0.56 to 0.83, respectively.

    CONCLUSION: The Malay-CAFU questionnaire is a valid and reliable instrument to assess the dependence level of stroke survivors and the upset level of informal stroke caregivers in Malaysia.

  16. Goh CH, Hamzah MR, Kandasamy R, Ghani ARI, Wong SH, Idris Z, et al.
    Med J Malaysia, 2020 11;75(6):666-671.
    PMID: 33219175
    INTRODUCTION: Chiari malformation (CM) is a disorder of mesodermal origin and is commonly associated with syringomyelia. Foramen magnum decompression is the first-line of standard treatment in symptomatic patients with a confirmed radiographic diagnosis. Magnetic resonance (MR) cine allows accurate evaluation of cerebrospinal fluid (CSF) physiology at the craniovertebral junction but often this is under-utilised in Malaysia.

    METHODS: In this series, we looked into nine cases of CM with syringomyelia from clinical and radiological perspective before and after surgery. The radiological parameters were herniated tonsillar length, syrinx: cord ratio, syrinx length and diameter. Flow velocity and morphologic changes in Chiari were illustrated.

    RESULTS: Seven patients showed either reduction in syrinx length, syrinx: cord ratio or both postoperatively. Clinical recovery somewhat varied in motor and sensory symptoms. Four patients gained better functional grade in modified Rankin scale (MRS) while the rest remained similar. The study highlighted the advantage of CSF flow dynamics information over MR anatomical radiographic improvement in addressing the neurologic and functional recovery. We also discussed the practicality of cine sequence in preoperative patient selection, syrinx analysis and postoperative flow evaluation in anticipation of clinical outcome.

    CONCLUSION: Phase-contrast cine MRI is a useful tool dictated by resource availability. We recommend its routine use in preoperative analysis and subsequent observational follow-up after surgery.

  17. Nandrajog P, Idris Z, Azlen WN, Liyana A, Abdullah JM
    Asian J Neurosurg, 2017 Jul-Sep;12(3):447-453.
    PMID: 28761523 DOI: 10.4103/1793-5482.180921
    BACKGROUND: The aim of the study is to compare the amplitude and latency of the P300 event-related potential (ERP) component between a control group and patients after mild traumatic brain injury (mTBI) during 1-7 days (short duration) and 2-3 months (long duration), and to compare the outcome of neuropsychological tests between the long duration postinjury and control study groups.

    MATERIALS AND METHODS: We studied responses to auditory stimulation in two main and one subgroups, namely the control healthy group (19 patients, both ERP and neuropsychology test done), the mTBI 1 group (17 patients, only ERP done within 7 days after injury), and the mTBI 2 subgroup (the 17 mTBI 1 patients in whom a repeated ERP together with neuropsychological testing was done at 2-3 months postinjury). Auditory evoked responses were studied with two different stimuli (standard and target stimuli), where the P300 amplitude and latency were recorded from three midline sites and results were compared between the groups, as were the neuropsychological test results.

    RESULTS: There was a significant prolongation of the target P300 latency values shown by the MBI 1 group measured at the central electrode when compared to the control group, which was also seen when the mTBI 1 and mTBI 2 groups were compared. The results of the P300 amplitude values measured at the frontal electrode showed the control group to have higher readings during the presentation of standard tones when compared to the mTBI 1 group. The mTBI 2 group performed better on some neuropsychological tests.

    CONCLUSION: The latency of P300 was significantly prolonged in early mTBI patients who improved over time, and the neuropsychological testing on mTBI 2 patients showed them to be comparable to the control group. The study indicates that ERP should be used as an additional modality of investigation in mTBI patients.
  18. Sharifuddin A, Adnan J, Ghani AR, Abdullah JM
    Med J Malaysia, 2012 Jun;67(3):305-8.
    PMID: 23082423 MyJurnal
    This was a prospective observational study done to evaluate the role of a repeat head CT in patients with mild traumatic brain injury. The aim was to evaluate wether the repeat head CT were useful in providing information that leads to any neurosurgical intervention. 279 adult patients with a mild head injury (GCS 13-15) were enrolled, and these comprised of patients with an initial traumatic intracranial haemorrhage not warranting any surgical intervention. All patients were subjected to a repeat head CT within 48 hours of admission and these showed no change or improvements of the brain lesion in 217 patients (79.2%) and worsening in 62 patients (20.8%). In thirty-one patients, surgical intervention was done following the repeat head CT. All of these patients had a clinical deterioration prior to the repeat head CT. Even if a repeat head CT had not been ordered on these patients, they would have had a repeat head CT due to deteriorating neurological status. When the 62 patients with a worsening repeat head CT were compared with the 217 patients with an improved or unchanged repeat head CT, they were found to have older age, lower GCS on admission, presenting symptoms of headache, higher incidence of multiple traumatic intracranial pathology and lower haemoglobin level on admission. On stepwise multiple logistic regression analysis, three factors were found to independently predict a worse repeat head CT (Table IV). This includes age of 65 years or older, GCS score of less than 15 and multiple traumatic intracranial lesion on initial head CT. As a conclusion, we recommend that, in patients with a MTBI and a normal neurological examination, a repeat cranial CT is not indicated, as it resulted in no change in management or neurosurgical intervention. Close monitoring is warranted in a subset of patients with risk factors for a worsening repeat head CT.
    Keywords: Computed tomography, brain injury, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
  19. Keong LH, Ghani AR, Awang MS, Sayuthi S, Idris B, Abdullah JM
    Acta Neurochir. Suppl., 2011;111:375-9.
    PMID: 21725785 DOI: 10.1007/978-3-7091-0693-8_63
    The aim of the study was to determine the prognostic value of a high augmentation index, which was a surrogate marker of arterial stiffness in patients with spontaneous intracerebral hemorrhage. The outcome was divided into two groups in which the following data were collected in a computer running SphygmoCor CvMS software version 8.2. Logistic regression analysis was carried out among significant variables to identify an independent predictor of 6-month outcome and mortality. Sixty patients were recruited into the study. Admission Glasgow Coma Scale score (OR, 0.7; 95% CI, 0.450-0.971; P=0.035), total white cell count (OR, 1.2; 95% CI, 1.028-1.453; P=0.023) and hematoma volume (OR, 1.1; 95% CI, 1.024-1.204; P=0.011) were found to be statistically significant for identifying poor 6-month outcome in multivariate analysis. Factors independently associated with mortality were a high augmentation index (OR, 8.6; 95% CI, 1.794-40.940; P=0.007) and midline shift (OR, 7.5; 95% CI, 1.809-31.004; P=0.005). Admission Glasgow Coma Scale score, total white cell count and hematoma volume were significant predictors for poor 6-month outcome, and a high augmentation index and midline shift were predictors for 6-month mortality in this study.
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